Key Takeaways

  • E/M levels should be validated using current MDM or qualifying time pathways.
  • Modifier 25 and 59 require documentation-supported distinctness, not routine usage.
  • Global package audits test whether separately billed services exceed included post-op care.
Last updated: February 2026

Avoiding common validation mistakes

  • Do not validate E/M by diagnosis count alone.
  • Do not accept modifier usage without note-level evidence.
  • Do not treat payment success as proof of coding correctness.

Validation should be evidence-first and criteria-driven.

Test Your Knowledge

What is the strongest basis for accepting modifier 25 during audit?

A
B
C
D